[Ronin]

Hi Felinefan!

First of all you are not alone, most of the other Pre-D's on the forum have gone through the same process you are going through now. Anger and frustration come with the turf largely because the Pre-D diagnosis is new and not well understood in the medical community.

First some background I have dug up when I was researching my own diagnosis. The Pre-Diabetic diagnosis was intended to catch young people who were developing Type-2 diabetes in their teens and 20's. Under the law of unintended consequences, more older adults were diagnosed as Pre-D's than the target group.

Behind this is a debate as to the source of diabetes in the first place. Is it genetic or is it environmental? If it is genetic then anyone with the genome is going to develop diabetes and the diet and exercise will delay the onset but not prevent it. If the cause is environmental then diet and exercise will prevent diabetes from happening. Is either source definitive? No.

Generally, I, and most of my fellow Pre-D's agree that one FBG reading above 100 does not relegate anyone to the world of Pre-D. A good diagnosis requires HbA1c testing (which you have already had) and potentially a test of your fasting C-Peptide levels and/or combined with and Oral Glucose Tolerance Test (OGTT) to determine the insulin output of your pancreas.

It is important to understand that most MD's who do not specialize in diabetes get these alerts from the medical community and when you get a FBG reading above 100 it sets off alarm bells (not to mention a fear of being sued if they do not diagnose and treat you properly and fast). So, you have the blood work and you get the diagnosis. Unfortunately, that leaves you both confused and angry.

Now a bit of reality. There have been tests on people with no signs of diabetes. Generally, their BG levels are well below 100 and tend to be in the 70's to low 80's even a few hours after eating a meal. Also, their A1c results tend to be below 5.0%. (Imortant note: HbA1c values are a weighted average that favors the pervious four to six weeks so they don't represent a realistic 90 day average. However, they are the best test to determine your abilty to control your BG levels over time and take out the spikes and valleys.)

So, just what is Pre-Diabetes and why do some of us accept that diagnosis while others do not? I can only answer for myself. I've had a lot of testing done, as well as doing a lot of testing on myself along with a lot of research. For me the Pre-D diagnosis is little more than fair warning. It is the time to take stock, make life-style changes, and to a large degree enter a phase of watchful-waiting for the condition to stabilize or get worse. In the mean time live your life.

On a personal level I already know that my pancreas produces insulin on the low end of normal and that my body response to glucose load is slower than a person with a fully functional pancreas. Eventually I will probably become a Type-1.5 and will need supplamental insulin to manage my BG levels. But not today.

I watch my diet, and when it comes to carbohydrates, I manage portion sizes. I also exercise a lot more than the average person -- being retired allows that to be easier than for a person with a job. But, having a job is not an excuse for not using the body whenever possible as opposed to using other means to get around.

I wish, as do most Pre-D's, that this was a clear cut case and a diagnosis actually means that you have a condition that can be treated or managed. Sorry, that just isn't what this is all about.

You wil have emotional ups and downs on this journey. We've all been here and we are willing to help to the extent that we can. Please be patient with us, and with yourself. The Pre-D diagnosis is not a death sentence, it is, at best, a warning sign on the pathway of life. It is your choice to take action or to ignore the facts.